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Potentiality made workable – exploring logics of care in reablement for older people

Published online by Cambridge University Press:  25 April 2018

MALENE NØRSKOV BØDKER*
Affiliation:
Center for Healthy Aging and Department of Public Health, University of Copenhagen, Denmark.
*
Address for correspondence: Malene Nørskov Bødker, Department of Public Health, Øster Farimagsgade 5, P.O.B. 2099, DK-1014 Copenhagen K, Denmark E-mail: [email protected]

Abstract

In the face of population ageing, Western health-care systems are currently demonstrating an immense interest in mobilising older people's potentials. With this agenda in mind, several countries have introduced reablement: a type of home care aimed at mobilising older people's potentials for independence by means of short-term training programmes. Based on extensive ethnographic fieldwork conducted in Denmark's home care sector, this paper explores how elder-care professionals translate the abstract notion of ‘potentiality’ into practice. Theoretically, the paper draws on Annemarie Mol's term ‘logic of care’. I demonstrate that professionals draw on two co-existing logics of care: a logic of reablement encapsulating ideals of successful ageing and life-long development; and a logic of retirement, which in contrast allows people at the end of life to retreat and engage in enjoyable activities. Professionals manage to balance these logics in order to live up to policy obligations while at the same time complying with moral standards of good care. However, very little is achieved in terms of increased independence. I argue that by narrowly focusing on bodily and quantifiable potentials, the ‘potentiality paradigm’ holds the risk of deeming older people to lack potential. In conclusion, I therefore encourage a more inclusive approach to elder-care and ageing that recognises the complexities of ageing, including older people's potentials for retreat and leisure.

Type
Article
Copyright
Copyright © Cambridge University Press 2018 

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References

Abrams, T. and Gibson, B. E. 2017. Putting Gino's lesson to work: actor–network theory, enacted humanity, and rehabilitation. Health, 21, 4, 425–40.Google Scholar
Aspinal, F., Glasby, J., Rostgaard, T., Tuntland, H. and Westendorp, R. G. J. 2016. New horizons: reablement – supporting older people towards independence. Age and Ageing, 45, 5, 574–8.Google Scholar
Birkeland, A., Tuntland, H., Førland, O., Jakobsen, F. F. and Langeland, E. 2017. Interdisciplinary collaboration in reablement – a qualitative study. Journal of Multidisciplinary Healthcare, 10, 2017, 195203.Google Scholar
Brown, N. 2003. Hope against hype – accountability in biopasts, presents and futures. Science Studies, 16, 2, 321.Google Scholar
City of Copenhagen, The Health and Care Committee 2015. Organisering af udrednings- og rehabiliteringsindsatsen 2016 [Organisation of the Assessment and Reablement Effort 2016]. City of Copenhagen, The Health and Care Committee, Copenhagen.Google Scholar
Cochrane, A., Furlong, M., McGilloway, S., Molloy, D. W., Stevenson, M. and Donnelly, M. 2016. Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. The Cochrane Database of Systematic Reviews, 2016, 10, CD010825.Google Scholar
Dahl, H. M., Eskelinen, L. and Hansen, E. B. 2015. Coexisting principles and logics of elder care: help to self-help and consumer-oriented service? International Journal of Social Welfare, 24, 3, 287–95.Google Scholar
Dillaway, H. E. and Byrnes, M. 2009. Reconsidering successful aging: a call for renewed and expanded academic critiques and conceptualizations. Journal of Applied Gerontology, 28, 6, 702–22.Google Scholar
European Commission 2012. The EU Contribution to Active Ageing and Solidarity Between Generations. Publications Office of the European Union, Luxembourg.Google Scholar
Friese, C. 2013. Realizing potential in translational medicine: the uncanny emergence of care as science. Current Anthropology, 54, S7, S12938.Google Scholar
Good, M.-J. D. 2001. The biotechnical embrace. Culture, Medicine and Psychiatry, 25, 4, 395410.Google Scholar
Grøn, L. 2016. Old age and vulnerability between first, second and third person perspectives. Ethnographic explorations of aging in contemporary Denmark. Journal of Aging Studies, 39, 2016, 2130.Google Scholar
Hjelle, K. M., Tuntland, H., Førland, O. and Alvsvåg, H. 2017. Driving forces for home-based reablement; a qualitative study of older adults’ experiences. Health & Social Care in the Community, 25, 5, 1581–9.Google Scholar
Hoeyer, K. 2010. An anthropological analysis of European Union (EU) health governance as biopolitics: the case of the EU tissues and cells directive. Social Science & Medicine, 70, 12, 1867–73.Google Scholar
Holstein, M. B. and Minkler, M. 2003. Self, society, and the ‘new gerontology’. The Gerontologist, 43, 6, 787–96.Google Scholar
Katz, S. 2000. Busy bodies: activity, aging, and the management of everyday life. Journal of Aging Studies, 14, 2, 135–52.Google Scholar
Kaufman, S. R. 2013. Fairness and the tyranny of potential in kidney transplantation. Current Anthropology, 54, S7, S5666.Google Scholar
King, A. I. I., Parsons, M., Robinson, E. and Jörgensen, D. 2012. Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial. Health & Social Care in the Community, 20, 4, 365–74.Google Scholar
Kjellberg, J. and Ibsen, R. 2010. Økonomisk evaluering af ‘Længst Muligt i Eget Liv’ i Fredericia Kommune [Economic Evaluation of ‘As Long as Possible in Your Own Life’]. Danish Institute for Health Services Research, Copenhagen.Google Scholar
Kjellberg, P. K. 2010. Hverdagsrehabilitering i Fredericia Kommune. 1. delevaluering: Notat udarbejdet til Fredericia Kommune [Reablement in Fredericia Municipality. First Evaluation: Note Prepared for Fredericia Municipality]. Danish Institute for Health Services Research, Copenhagen.Google Scholar
Kjellberg, P. K., Hauge-Helgestad, A., Madsen, M. H. and Rasmussen, S. R. 2013. Kortlægning af kommunernes erfaringer med rehabilitering på ældreområdet [Mapping of the Municipalities’ Experiences with Reablement in the Eldercare Sector]. National Board of Social Services, Copenhagen.Google Scholar
Lamb, S., Robbins-Ruszkowski, J. and Corwin, A. I. 2017. Introduction. Successful aging as a twenty-first-century obsession. In Lamb, S. (ed.), Successful Aging as a Contemporary Obsession: Global Perspectives. Rutgers University Press, New Brunswick, New Jersey, 123.Google Scholar
Legg, L., Gladman, J., Drummond, A. and Davidson, A. 2016. A systematic review of the evidence on home care reablement services. Clinical Rehabilitation, 30, 8, 741–9.Google Scholar
Lewin, G. F., Alfonso, H. S. and Alan, J. J. 2013. Evidence for the long term cost effectiveness of home care reablement programs. Clinical Interventions in Aging, 8, 2016, 1273–81.Google Scholar
Martinson, M. and Berridge, C. 2015. Successful aging and its discontents: a systematic review of the social gerontology literature. The Gerontologist, 55, 1, 5869.Google Scholar
Mattingly, C. 2010. The Paradox of Hope: Journeys Through a Clinical Borderland. University of California Press, Berkeley, California.Google Scholar
Meldgaard Hansen, A. 2016. Rehabilitative bodywork: cleaning up the dirty work of homecare. Sociology of Health & Illness, 38, 7, 1092–105.Google Scholar
Meldgaard Hansen, A. and Kamp, A. 2018. From carers to trainers: professional identity and body work in rehabilitative eldercare. Gender, Work & Organization, 25, 1, 6376.Google Scholar
Ministry of Children, Gender Equality, Integration and Social Affairs 2014 a. Fremsættelse af lovforslag L 25: Forslag til lov om ændring af lov om social service (rehabiliteringsforløb og hjemmehjælp m.v.) [Introduction of Bill L 25: Bill on Amendment of Act on Social Services (Reablement Programmes and Home Care etc.)]. Ministry of Children, Gender Equality, Integration and Social Affairs, Copenhagen.Google Scholar
Ministry of Children, Gender Equality, Integration and Social Affairs 2014 b. ‘Livet skal leves hele livet’. Regeringens politiske oplæg til opfølgning på Hjemmehjælpskommissionen [‘Life Should Be Lived Throughout Life’. The Government's Political Proposal to Follow Up on the Home Care Commission]. Ministry of Children, Gender Equality, Integration and Social Affairs, Copenhagen.Google Scholar
Ministry of Children, Gender Equality, Integration and Social Affairs 2014 c. Lov om ændring af lov om social service [Law on Amendment of Act on Social Services]. Ministry of Children, Gender Equality, Integration and Social Affairs, Copenhagen.Google Scholar
Moe, A. and Brataas, H. V. 2016. Interdisciplinary collaboration experiences in creating an everyday rehabilitation model: a pilot study. Journal of Multidisciplinary Healthcare, 9, 2016, 173–82.Google Scholar
Moe, A., Ingstad, K. and Brataas, H. V. 2017. Patient influence in home-based reablement for older persons: qualitative research. BMC Health Services Research, 17, 736, 110.Google Scholar
Mol, A. 2008. The Logic of Care: Health and the Problem of Patient Choice. Routledge, London.Google Scholar
Mol, A., Moser, I. and Pols, J. (eds) 2010. Care in Practice: On Tinkering in Clinics, Homes and Farms. Transcript-Verlag, Bielefeld, Germany.Google Scholar
Pols, J. and Willems, D. 2011. Innovation and evaluation: taming and unleashing telecare technology. Sociology of Health & Illness, 33, 3, 484–98.Google Scholar
Rabiee, P. and Glendinning, C. 2011. Organisation and delivery of home care re-ablement: what makes a difference? Health & Social Care in the Community, 19, 5, 495503.Google Scholar
Randström, K. B., Wengler, Y., Asplund, K. and Svedlund, M. 2014. Working with ‘hands-off’ support: a qualitative study of multidisciplinary teams’ experiences of home rehabilitation for older people. International Journal of Older People Nursing, 9, 1, 2533.Google Scholar
Rollnick, S. and Miller, W. R. 1995. What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy, 23, 4, 325–34.Google Scholar
Rowe, J. W. and Kahn, R. L. 1997. Successful aging. The Gerontologist, 37, 4, 433–40.Google Scholar
Star, S. L. and Strauss, A. 1999. Layers of silence, arenas of voice: the ecology of visible and invisible work. Computer Supported Cooperative Work, 8, 1/2, 930.Google Scholar
Svendsen, M. N. 2011. Articulating potentiality: notes on the delineation of the blank figure in human embryonic stem cell research. Cultural Anthropology, 26, 3, 414–37.Google Scholar
Svendsen, M. N. and Koch, L. 2013. Potentializing the research piglet in experimental neonatal research. Current Anthropology, 54, S7, S11828.Google Scholar
Taussig, K.-S., Hoeyer, K. and Helmreich, S. 2013. The anthropology of potentiality in biomedicine: an introduction to supplement 7. Current Anthropology, 54, S7, S314.Google Scholar
Tavory, I. and Timmermans, S. 2014. Abductive Analysis: Theorizing Qualitative Research. University of Chicago Press, Chicago.Google Scholar
Tessier, A., Beaulieu, M.-D., Mcginn, C. A. and Latulippe, R. 2016. Effectiveness of reablement: a systematic review. Healthcare Policy, 11, 4, 4959.Google Scholar
Thompson, C. 2007. Making Parents: The Ontological Choreography of Reproductive Technologies. MIT Press, Cambridge, Massachusetts.Google Scholar
Timmermans, S. and Buchbinder, M. 2013. Potentializing newborn screening. Current Anthropology, 54, S7, S2635.Google Scholar
Tutton, R. 2011. Promising pessimism: reading the futures to be avoided in biotech. Social Studies of Science, 41, 3, 411–29.Google Scholar
Whitehead, P. J., Worthington, E. J., Parry, R. H., Walker, M. F. and Drummond, A. E. 2015. Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review. Clinical Rehabilitation, 29, 11, 1064–76.Google Scholar
Wilde, A. and Glendinning, C. 2012. ‘If they're helping me then how can I be independent?’ The perceptions and experience of users of home-care re-ablement services. Health and Social Care in the Community, 20, 6, 583–90.Google Scholar
World Health Organization 2002. Active Ageing: A Policy Framework. World Health Organization, Geneva.Google Scholar